Objectives week 1

Question 1

List the vitals

Answer 1

Heart rate
Respiratory rate
Blood pressure
Temperature

Question 2

Three most common locations for checking a heart rate.

Answer 2

Radial artery
Brachial artery
Carotid artery

Question 3

How long do you check a heart rate?

Answer 3

If RRR, measure for 15 seconds and x4. If not, count for full 60 seconds.

Question 4

How long should you measure respiratory rate?

Answer 4

A full 60 seconds

Question 5

Normal heart rate?

Answer 5

60-100 bpm

Question 6

Normal respiratory rate?

Answer 6

12-20 respirations per minute

Question 7

What is the gold standard location when taking a temperature?

Answer 7

Rectal

Question 8

Will axillary be higher or lower than oral?

Answer 8

Lower

Question 9

When using the tympanic thermometer, which way do you face the tool?

Answer 9

Towards the eyes, otherwise you can get an abnormally low reading.

Question 10

What other observations would be made while measuring respirations?

Answer 10

Fruity breath, how hard it is to breathe, what position the person has to place themselves in, accessory muscles

Question 11

What populations have lower or higher of the following:
BP
RR
Temperature

Answer 11

BP: higher = children and hypertension, lower = elderly and hypotension
Temp: higher = children (febrile seizures), lower = elderly (can mask fevers)

Question 12

What are some alternative places to measure BP?

Answer 12

Thigh, wrist, and forearm

Question 13

What are five common errors in measuring BP?

Answer 13

1. Stethoscope is not turned to bell
2. Using bell
3. Earpieces pointing toward eyes
4. Bell is sealed
5. Brachial artery is found

Question 14

How do you increase Korotkoff sounds?

Answer 14

Place cuff on arm
Have them raise arm above head
Inflate cuff to 60mmHg over normal
(Have them lower arm - cuff will deflate about 30mmHg)
Continue as normal

Question 15

tangential lighting

Answer 15

Lighting used to create shadows to better view bumps

Question 16

What are physical exam positions?

Answer 16

Standing
Sitting
Sitting and leaning forward
Supine
Supine on left side
Supine with legs flexed

Question 17

What are the cardinal techniques of examination?

Answer 17

Inspection - looking
Palpitation - feeling
Percussion - tapping
Auscultation - listening using stethoscope

Question 18

What are the 6 steps in clinical reasoning?

Answer 18

1. Identify abnormal findings
2. localize findings anatomically
3. Interpret
   4, Make hypothesis
4. Test hypothesis
5. Develop a plan

Question 19

What is CAGE questioning?

Answer 19

Cutting down
Annoyance when criticized
Guilty feelings
Eye openers
It is used to assess alcohol addiction or illicit drug use

Question 20

How do you diagnose hypertension?

Answer 20

The systolic goes up by 20's, and diastolic goes up by 10's. 
Normal: 120/80
prehypertension: 120-139/80-89
hypertension stage 1: 140-159/90-99
hypertension stage 2: 160+/100+

Question 21

Components of skilled interviewing

Answer 21

Active listening
Empathetic responses
guided questioning
nonverbal communication
validation
reassurance
partnering
summarization
transitions
empowering the patient

Question 22

Making a problem list: what do you list first?

Answer 22

The most serious problem